The health care system I worked for began its lean journey as many organizations do; using lean tools and rapid improvement or kaizen events. We experienced huge improvements and were excited about our results. However, after about four years our operational managers started to express frustration that we were not sustaining breakthrough improvement. We realized that we had gaps in our approach to improvement.
That is when we began work to design and implement a lean management system. Developing the lean management system required us to move away from a project mentality for improvement to a system that builds a continuous improvement culture. The overall objective of a lean management system is to develop people to solve problems and improve performance.
From my experience working in healthcare and teaching a lean management system to healthcare organizations around the world, I have found many benefits to implementing this type of system. These benefits include learning and understanding your business, creating alignment throughout your organization, being able to measure and review your performance in real time, enabling problem-solving in the gemba, and sustaining improvements.
Learning and understanding your business
Often leaders do not get a full picture of what is going on within each unit, or department. This information is critical in understanding your business. The fact is once we started listening to our frontline staff we learned a lot of things that we had no idea about.
Many of the elements of a lean management system can help you gain a deeper understanding of your business, such as the stat sheet, or status sheet. This is a way to open communication between a leader and direct report by asking a set of questions that are designed to help the leader understand flow, processes, and hear about issues on a regular basis.
Creating alignment throughout your organization
Another benefit of a lean management system is creating alignment throughout your organization. This means that all staff is aware of the strategies and True North of the organization and they have visibility into how their work impacts those. A lean management system creates alignment by forming an information flow process.
A lean management system forms a process where information flows from the CEO to the front-line staff and from the frontline staff to the CEO, and each level in between. In the ideal state information regarding the status of the business, continuous improvement, and issues that need escalation flow from the staff to the CEO; where communications about True North and strategy flow from the CEO to the staff. Coaching, mentoring, and barrier removal also flow in this same direction (from leadership levels to front-line staff).
The Ability to measure and review your performance
Measuring and reviewing performance is critical for any business. A lean management system gives an organization the ability to review metrics and respond to performance. This allows for rapid experiments and enables the organization to respond quickly. The lean management system elements including visual management, monthly performance review meetings, and scorecards all encourage measuring and reviewing data methodically.
The monthly performance review meeting is designed to connect the work of the unit to the work of the system. During the meeting, managers communicate performance and resource needs. The meeting also allows for forced reflection around performance.
Enabling problem-solving in the gemba
Enabling problem-solving in the gemba is a great way to engage teams and develop people, which is the core objective of implementing a lean management system. Those closest to the work are the ones who have the most information about what the problems are and how to solve them. Coaching staff to solve problems at their level will go a long way in building a continuous improvement culture. Two elements that can help reinforce this are performance huddles.
Part of the performance huddle is reviewing improvement ideas. This is where teams start to get engaged because things that matter in their daily work are being addressed. Working through implementing an improvement idea gives staff experience in problem-solving and allows the unit leader to coach their thinking and help them develop.
A lean management system provides the framework and structure to sustain improvements and to continuously study and adjust to achieve goals. The creation and implementation of standard work is key to sustaining improvements. Two elements of a lean management system that enable us to sustain improvements are leader standard work and managing to standards, or kamishibai.
Leader standard work helps leaders model the way, support teams, develop direct reports, and reduce variation while improving performance. It’s like Jim Womack of the Lean Enterprise Institute said, “All processes have a desperate desire to head toward chaos, to get worse fast, and the only thing standing in the way is management.”
Because standard work and managing to it is so important to the sustainment of improvement, the lean management system includes kamishibai, or process observation. This component of the lean management system is about maintaining and improving standard work; as well as understanding whether the standards are delivering on the expected outcome.
Simply put, there are many benefits to adopting a lean management system. The goal of the system is to develop people to solve problems and improve performance. Please note that while I pulled out certain components of the lean management system that we teach at Catalysis to include in this post, these components would not have the same impact if they were implemented independent of the entire system. I like to think of a lean management system as a brick wall, it is made up of many different components (or bricks) and if one brick were removed from the wall, the wall would crumble. This holds true for a lean management system as well. The components are interdependent.
Patsy Engel, Faculty
Related Blogs: Simple Steps for Creating a Status Sheet, Dos and Dont's of Implementing a Daily Huddle , Dos and Don'ts of Implementing Process Observation, Four Questions to Consider When Creating Leader Standard Work
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